Individual provider Active NPI

Justin Adams Crocker

  • Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1447410394
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2014-00470 Issued in NC
Practice address
3480 Wake Forest Rd
Suite 500
Raleigh, NC 27609-7376
Phone
(919) 862-5075
NPI assigned
Jun 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2014-00470 NC Primary

Addresses

Primary practice location

3480 Wake Forest Rd
Suite 500
Raleigh, NC 27609-7376

Mailing address

PO Box 63362
Charlotte, NC 28263-3362
Phone (919) 684-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140626002395 NC Practitioner - Gastroenterology 9335376102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

10207 Cerny St
Raleigh, NC 27617-4880
Phone (919) 684-8111

3400 Wake Forest Rd
Suite 310
Raleigh, NC 27609-7317
Phone (919) 620-4855

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy85
Upper gastrointestinal (GI) endoscopy for acid reflux51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014-00470NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

10207 Cerny St
Ste 200
Raleigh, NC 27617
Phone (919) 385-7675

3300 Executive Dr
Ste 101
Raleigh, NC 27609
Phone (919) 862-5075

3480 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 862-5075

3480 Wake Forest Rd
Ste 500
Raleigh, NC 27609
Phone (919) 684-6437

10207 Cerny St
Ste 210
Raleigh, NC 27617
Phone (800) 266-3853

Interoperability endpoints

  • Direct secure messaging: jcrocker221867@direct.medicine.duke.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1447410394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 WAKE FOREST RD",
            "address_2": "SUITE 500",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097376",
            "telephone_number": "919-862-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "JUSTIN",
        "middle_name": "ADAMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2014-00470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.